Dr. Reeves' Notes: 10% dextrose superior to hypotonic lidocaine in finger and thumb OA. Injection was primarily periarticular here (medial and lateral) and in this study 10% dextrose was superior with no obvious effect of control solution.

Subjects had finger pain an average of 5 years and met radiographic criteria for finger osteoarthritis. Treatment consisted of injection of 1/2 ml of 10% dextrose versus hypotonic lidocaine on either side of the joint using a tiny needle and slight sedation for discomfort. Rest pain was not a good variable to look at since it was often absent at study onset, but movement pain improved significantly more (42% versus 15%; p = .027) as did range of motion (+8 degrees versus minus 8.1 degrees; p = .003) Note an average joint was calculated for each patient to avoid statistical magnification by multiple joints in each patient.

INTERVENTION: One half milliliter (0.5 mL) of either 10% dextrose and 0.075% xylocaine in bacteriostatic water (active solution) or 0.075% xylocaine in bacteriostatic water (control solution) was injected on medial and lateral aspects of each affected joint. This was done at 0, 2, and 4 months with assessment at 6 months after first injection.

OUTCOME MEASURES: One-hundred millimeter (100 mm) Visual Analogue Scale (VAS) for pain at rest, pain with joint movement and pain with grip, and goniometrically-measured joint flexion. RESULTS: Pain at rest and with grip improved more in the dextrose group but not significantly. Improvement in pain with movement of fingers improved significantly more in the dextrose group (42% versus 15% with a p value of .027). Flexion range of motion improved more in the dextrose group (p = .003). Side effects were minimal.

CONCLUSION: Dextrose prolotherapy was clinically effective and safe in the treatment of pain with joint movement and range limitation in osteoarthritic finger joints.